Improving the Detection of Hypertension and its Control
改善高血压的检测及其控制
基本信息
- 批准号:10573169
- 负责人:
- 金额:$ 208.83万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-02-15 至 2026-01-31
- 项目状态:未结题
- 来源:
- 关键词:AdultAgeAlbuminsAmbulatory Blood Pressure MonitoringAntihypertensive AgentsAsianBlack raceBlood PressureBlood Pressure MonitorsCardiovascular DiseasesCreatinineDataDetectionDevicesDiagnosisDiastolic blood pressureEchocardiographyElderlyEnrollmentEthnic OriginEthnic PopulationGuidelinesHealthHispanicHome Blood Pressure MonitoringHourHypertensionIndividualLeft Ventricular MassLos AngelesMeasurementMeasuresMedicalMethodsMinorityNew YorkNot Hispanic or LatinoOffice VisitsOrganOutcomeParticipantPharmaceutical PreparationsPublic HealthRaceRandomizedRecommendationReference StandardsReportingReproducibilityResearch DesignRisk FactorsSamplingSiteTestingVisitWomanage differenceage groupawakebiomarker validationblood pressure controldisability-adjusted life yearshypertension controlhypertensiveimprovedindexingmodifiable riskprimary outcomescreeningsecondary outcomesexurinaryyears of life lostyoung adult
项目摘要
Blood pressure (BP) measured in the office is used to diagnose hypertension and guide BP management for
adults taking antihypertensive medication. Guidelines recommend measuring BP outside of the office using
ambulatory BP monitoring (ABPM) or home BP monitoring (HBPM) to confirm office BP, averaged across
multiple visits. The evidence supporting this recommendation is weak since most prior studies compared BP
on ABPM or HBPM against office BP measured at a single visit. Guidelines also recommend that ABPM be
performed over a 24-hour period and HBPM be based on 2 measurements in the morning (AM) and 2
measurements in the evening (PM) for 7 days. Many guidelines endorse ABPM as the reference standard for
out-of-office BP monitoring, but there are few data comparing ABPM to HBPM conducted for 7 days. We
recently completed a study of 400 adults that compared BP measured during 3 office visits, on ABPM, and
HBPM, each conducted following guideline-recommended approaches. The study found (1) BP on HBPM was
associated with left ventricular mass index (LVMI), a marker of target end-organ damage, independent of office
BP and BP on ABPM, (2) office BP and BP on ABPM were not associated with LVMI, independent of BP on
HBPM, (3) HBPM was more reliable (i.e. reproducible) than ABPM and office BP, and (4) office BP was more
reliable than ABPM. These results suggest a new paradigm that HBPM is superior to ABPM and office
BP, and ABPM is not needed when office BP and HBPM are both performed. However, no one in this
study was taking antihypertensive medication, few older adults were enrolled, and a minority had high office
BP. These findings need to be tested in a larger study with broader generalizability. We propose to enroll 1,696
adults in New York, NY, Birmingham, AL, and Los Angeles, CA with screening systolic/diastolic BP <160/100
mm Hg; 50% of whom will be taking antihypertensive medication. The sample will be diverse based on age
(33% in each age group: 18-39, 40-59, and ≥60 years), sex (50% women), race/ethnicity (≥25% non-Hispanic
white, ≥25% non-Hispanic Black, ≥25% Hispanic, and ≥10% Asian), and office BP level (50% with office BP
≥130/80 mm Hg). Office BP will be measured at 3 visits. ABPM will be performed over two 24-hour periods and
HBPM will be performed with 2 AM and 2 PM measurements per day over two 7-day periods. Two markers of
target end-organ damage – LVMI on echocardiogram and albumin-to-creatinine ratio – will be assessed. We
will determine whether BP on HBPM is more strongly associated with target end-organ damage than office BP
and awake BP on ABPM (Primary Aim 1). We will determine if HBPM is more reliable than office BP and
awake BP on ABPM (Primary Aim 2). We will also determine whether the findings are consistent using asleep
BP and 24-hour BP instead of awake BP, and investigate potential differences among age, sex, and
race/ethnicity subgroups (Secondary Aims). The study will determine the best approach to measure BP for
diagnosing and managing hypertension, which has the potential to improve the health of millions of US adults.
在办公室测量血压(BP)用于诊断高血压和指导血压管理
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Kristi Reynolds其他文献
Kristi Reynolds的其他文献
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{{ truncateString('Kristi Reynolds', 18)}}的其他基金
Assessing the Burden of Diabetes by Type in Children, Adolescents and Young Adults (DiCAYA) - Component B (18 to < 45 yrs)
按类型评估儿童、青少年和年轻人的糖尿病负担 (DiCAYA) - B 部分(18 岁至 < 45 岁)
- 批准号:
10636654 - 财政年份:2020
- 资助金额:
$ 208.83万 - 项目类别:
Assessing the Burden of Diabetes by Type in Children, Adolescents and Young Adults (DiCAYA) - Component B (18 to < 45 yrs)
按类型评估儿童、青少年和年轻人的糖尿病负担 (DiCAYA) - B 部分(18 岁至 < 45 岁)
- 批准号:
10223096 - 财政年份:2020
- 资助金额:
$ 208.83万 - 项目类别:
Assessing the Burden of Diabetes by Type in Children, Adolescents and Young Adults (DiCAYA) - Component B (18 to < 45 yrs)
按类型评估儿童、青少年和年轻人的糖尿病负担 (DiCAYA) - B 部分(18 岁至 < 45 岁)
- 批准号:
10414406 - 财政年份:2020
- 资助金额:
$ 208.83万 - 项目类别:
Ambulatory blood pressure and falls in older treated patients with hypertension
接受治疗的老年高血压患者的动态血压和跌倒情况
- 批准号:
10163696 - 财政年份:2018
- 资助金额:
$ 208.83万 - 项目类别:
Population-based diabetes in youth registry. SEARCH For Diabetes in Youth, Phase 4, California Site
青年登记中基于人群的糖尿病。
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9753808 - 财政年份:2015
- 资助金额:
$ 208.83万 - 项目类别:
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